Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT03290391 |
Other study ID # |
H-36706 |
Secondary ID |
R01DA045547 |
Status |
Completed |
Phase |
Phase 4
|
First received |
|
Last updated |
|
Start date |
September 19, 2018 |
Est. completion date |
April 6, 2022 |
Study information
Verified date |
March 2023 |
Source |
Boston Medical Center |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
This study, "Linking Infectious and Narcology Care - Part II (LINC-II)," will implement and
evaluate a multi-faceted intervention (LINC-II), via a two-armed randomized controlled trial
among 240 HIV-infected PWID in St. Petersburg. LINC-II, comprised of pharmacological therapy
(i.e., rapid access to ART and receipt of naltrexone for opioid use disorder) and 12 months
of strengths-based case management, will assess HIV outcomes (e.g., HIV viral load
suppression), impact on care systems and cost-effectiveness of the intervention.
Description:
Russia and Eastern Europe continue to have one of the fastest growing HIV epidemics in the
world, with highest transmission risks among people who inject drugs (PWID) and their sexual
partners. While routine HIV testing within addiction treatment systems in Russia (i.e.,
narcology hospitals) is the norm, links between the narcology and HIV care systems are
limited and ineffective. In St. Petersburg 50-60% of PWID are HIV-infected, yet among this
population less than 10% are on antiretroviral therapy (ART). For Russia to make progress
toward the UNAIDS 90-90-90 targets (i.e., 90% aware of HIV diagnosis, 90% of those diagnosed
on ART and 90% of those on ART with suppressed HIV viral load [HVL]), a bold new strategy is
required. The objective of this study, "Linking Infectious and Narcology Care - Part II
(LINC-II)," is to implement and evaluate, via a two-armed randomized controlled trial among
240 HIV-infected PWID, a multi-faceted intervention combining pharmacological therapy (i.e.,
rapid access to ART and receipt of naltrexone for opioid use disorder) and 12 months of
strengths-based case management.
The central hypothesis is that LINC-II will lead to marked progress toward the achievement of
the 90-90-90 HIV cascade of care targets among HIV-infected PWID, relative to current
standard of care, and that LINC-II will facilitate health system coordination of narcology
and HIV care. LINC-II aims to: 1) evaluate the effectiveness of LINC-II on undetectable HVL
at 12 months (primary outcome), initiation of ART within 28 days of randomization, change in
CD4 count from baseline to 12 months, retention in HIV care (i.e., ≥ 1 visit to medical care
in 2 consecutive 6 month periods), and undetectable HVL at 6 months; 2) evaluate the impact
of LINC-II on coordinated care across the narcology and HIV health care systems, using mixed
methods data from health care providers, administrators, and patients; and 3) evaluate the
cost-effectiveness of the intervention to inform policy makers on scaling up the LINC-II
approach both within Russia and other countries with HIV epidemics driven by injection drug
use.